The primary aim of this study was to examine youth risk behaviors in relation to: (a) making a smoking quit attempt, and (b) successful cessation among adolescent smokers. Data were analyzed from the public use dataset of the 2003 national school-based Youth Risk Behavior Survey. The sample consisted of 2,033 students (weighted mean age of 16.3 years, 49.8% female, 73.6% White) who reported a history of daily smoking. While almost two-thirds (63.5%) of adolescent smokers reported making a quit attempt in the last year, only 10% of those were able to successfully quit. Factors associated with making a quit attempt included depression and participating in sports while high-risk sexual activity and engaging in substance use other than alcohol or marijuana were negatively related to making a quit attempt. Externalizing health behaviors (e.g., fighting, drug use, and high risk sexual activity) were associated with decreased likelihood of cessation. Findings from this study may inform efforts to develop more effective smoking prevention and treatment programs for youth.
Smoking cessation; Quit attempts; Health risk behaviors; Adolescents
College freshmen face a variety of academic and social challenges as they adjust to college life that can place them at risk for a number of negative outcomes, including depression and alcohol-related problems. Orientation classes that focus on teaching incoming students how to better cope with college-oriented stress may provide an opportunity to prevent the development of these adjustment problems. This article outlines a program based on behavioral activation that can be integrated into college orientation programs to provide a more comprehensive orientation experience. Data are presented from an initial pilot study in which 71 first-semester freshman at the University of Maryland participated in a 15-week, 2 hr per week orientation class (n = 37 in the behavioral activation-enhanced orientation classes and n = 34 in the control orientation as usual classes). Students’ depression and alcohol use were evaluated at the beginning, middle, and end of the course. Results indicated a Time × Group interaction such that problem drinking (but not consumption) was significantly reduced across assessments in the behavioral activation classes and largely unchanged in the standard classes. No difference was observed in depression scores; however, fairly low depression scores across the 3 time points may have limited the opportunity to observe any meaningful impact of the orientation classes on depression. The authors conclude with a discussion of the implications of their findings for preventing adjustment problems among incoming college students and future directions.
behavioral activation; college students; alcohol problems; depression
Latinos with limited English proficiency (LEP) experience multiple barriers to accessing efficacious mental health treatments. Using a stage model of behavioral therapies research, this Stage 1b investigation evaluated the Brief Behavioral Activation Treatment for Depression (BATD), an intervention which may be well-equipped to address existing treatment barriers.
A sample of 10 Latinos with LEP and depressive symptomatology participated in a 10-session,direct (i.e., literal) Spanish-language translation of BATD, with no other cultural modifications. Participants were assessed at each session for depressive symptomatology and for the proposed BATD mechanisms: activity engagement and environmental reward. One month after treatment, participants were reassessed and interviewed to elicit feedback about BATD.
Hierarchical Linear Model analyses were used to measure BATD outcomes. Results showed depressive symptomatology decreased (p<.001), while both activation (p = .04) and environmental reward (p = .02) increased over the course of BATD. Increases in activation corresponded concurrently with decreases in depression (p = .01), while environmental reward preceded decreases in depressive symptomatology (all p’s≤ .04). Follow-up analyses revealed sustained clinical gains in depression and activation, and an increase in environmental reward at follow-up.
Participant interviews conducted one month after treatment conclusion indicated that BATD is an acceptable treatment for our sample of interest. Despite the limitations inherent to a study restricted to sample of ten, preliminary outcomes of this Stage I research suggest that members of this otherwise underserved group showed improvements in depressive symptomatology and are willing to participate in and adhere to BATD. The study’s positive outcomes suggest that a Stage II randomized clinical trial is a logical next step.
Spanish-speaking Latinos; depression; behavioral activation; treatment development
Childhood emotional abuse (CEA) is a pervasive problem associated with negative sequelae such as elevated depressive symptoms. Key stress-related genes, such as the 5-HTTLPR polymorphism, interact with childhood abuse to produce elevated depressive symptoms in older adolescent girls, but not in older adolescent boys. To date, studies have not examined this relationship as a function of CEA specifically or among younger adolescents. To extend prior work, we examined the effects of the 5-HTTLPR and CEA on depressive symptoms among 10–12-year-old youth. Based on previous findings, we expected a main effect of CEA on depressive symptoms among all youth, but only expected an interactive effect between the 5-HTTLPR and CEA on depressive symptoms in girls. In the current study, 222 youth (mean age 11.02 years, 44.1% girls, 51.6% Caucasian, 33.0% African American, 2.7% Latino, and 12.7% other) and their parent(s)/guardian(s) completed the Revised Child Anxiety and Depression Scale and the Emotional Abuse subscale of the Childhood Trauma Questionnaire and provided saliva samples for genotyping the 5-HTTLPR. Results indicate that CEA, but not the 5-HTTLPR, was related to elevated depressive symptoms among boys. Among girls, each copy of the s allele of the 5-HTTLPR was related to increased depressive symptoms, but only for those who had experienced CEA. Our results extend prior findings by specifically examining CEA and by focusing on 10–12-year-old youth. These results, although preliminary, suggest that focusing on the interplay between putative genetic markers and a broader range of environmental events, such as CEA, might allow researchers to determine factors differentially influencing the later emergence of sex differences in depressive symptoms.
emotional abuse; depressive symptoms; 5-HTTLPR; sex differences; early adolescence
Major depressive disorder is highly prevalent among Latinos with limited English language proficiency in the United States. Although major depressive disorder is highly treatable, barriers to depression treatment have historically prevented Latinos with limited English language proficiency from accessing effective interventions. The project seeks to evaluate the efficacy of behavioral activation treatment for depression, an empirically supported treatment for depression, as an intervention that may address some of the disparities surrounding the receipt of efficacious mental health care for this population.
Following a pilot study of behavioral activation treatment for depression with 10 participants which yielded very promising results, the current study is a randomized control trial testing behavioral activation treatment for depression versus a supportive counseling treatment for depression. We are in the process of recruiting 60 Latinos with limited English language proficiency meeting criteria for major depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders 4th and 5th Edition for participation in a single-center efficacy trial. Participants are randomized to receive 10 sessions of behavioral activation treatment for depression (n = 30) or 10 sessions of supportive counseling (n = 30). Assessments occur prior to each session and at 1 month after completing treatment. Intervention targets include depressive symptomatology and the proposed mechanisms of behavioral activation treatment for depression: activity level and environmental reward. We will also examine other factors related to treatment outcome such as treatment adherence, treatment satisfaction, and therapeutic alliance.
This randomized controlled trial will allow us to determine the efficacy of behavioral activation treatment for depression in a fast-growing, yet highly underserved population in US mental health services. The study is also among the first to examine the effect of the proposed mechanisms of change of behavioral activation treatment for depression (that is, activity level and environmental reward) on depression over time. To our knowledge, this is the first randomized controlled trial to compare an empirical-supported treatment to a control supportive counseling condition in a sample of depressed, Spanish-speaking Latinos in the United States.
Clinical Trials Register: NCT01958840; registered 8 October 2013.
Behavioral activation; Randomized controlled trial; Latinos; Depression; Spanish-speaking
The aryl hydrocarbon receptor (AHR) regulates the toxic effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). The AHR repressor (AHRR) is an AHR target gene and functions as a ligand-induced repressor of AHR; however, its mechanism of inhibition is controversial. Recently, we reported that TCDD-inducible poly (ADP-ribose) polymerase (TiPARP; ARTD14) also acts as a repressor of AHR, representing a new player in the mechanism of AHR action. Here we compared the ability of AHRR- and TiPARP-mediated inhibition of AHR activity. TCDD increased AHRR mRNA levels and recruitment of AHRR to cytochrome P450 1A1 (CYP1A1) in MCF7 cells. Knockdown of TiPARP, but not AHRR, increased TCDD-induced CYP1A1 mRNA and AHR protein levels. Similarly, immortalized TiPARP−/− mouse embryonic fibroblasts (MEFs) and AHRR−/− MEFs exhibited enhanced AHR transactivation. However, unlike TiPARP−/− MEFs, AHRR−/− MEFs did not exhibit increased AHR protein levels. Overexpression of TiPARP in AHRR−/− MEFs or AHRRΔ8, the active isoform of AHRR, in TiPARP−/− MEFs reduced TCDD-induced CYP1A1 mRNA levels, suggesting that they independently repress AHR. GFP-AHRRΔ8 and GFP-TiPARP expressed as small diffuse nuclear foci in MCF7 and HuH7 cells. GFP-AHRRΔ8_Δ1-49, which lacks its putative nuclear localization signal, localized to both the nucleus and the cytoplasm, while the GFP-AHRRΔ8_Δ1-100 mutant localized predominantly in large cytoplasmic foci. Neither GFP-AHRRΔ8_Δ1-49 nor GFP-AHRRΔ8_Δ1-100 repressed AHR. Taken together, AHRR and TiPARP repress AHR transactivation by similar, but also different mechanisms.
aryl hydrocarbon receptor; AHR (Aryl hydrocarbon receptor) repressor; TCDD (2,3,7,8-tetrachlorodibenzo-p-dioxin)-inducible-poly (ADP-ribose) polymerase; ADP-ribosyltransferase diptheria-like toxin 14; 2,3,7,8-tetrachlorodibenzo-p-dioxin; transactivation
Although adolescents frequently engage in a variety of risky behaviors, much remains unknown about the specific etiologies of such tendencies. Candidate genetic variants, such as the COMT Val158Met polymorphism, may be related to risk-taking propensity, particularly as this variant is linked to functional enzymatic differences influencing dopamine function in regions including the prefrontal cortex. The present study aimed to examine the COMT Val158Met variant in relation to risk taking propensity in a community sample of youth. As part of a larger longitudinal study on adolescent risk behaviors, 223 youths (average age 11.3 years) from the metropolitan Washington D.C. area completed a measure of risk-taking propensity, the Balloon Analogue Risk Task-Youth Version (BART-Y), and provided saliva samples for DNA extraction and genotyping. Results indicate that females, but not males, who are carriers of the COMT158Met allele had higher risk-taking propensity scores on the BART-Y compared to Val homozygotes. Analyses were also conducted in the 111 European American participants, and results were consistent with those of the full sample analyses. This study represents the first investigation of a genetic substrate of risk-taking propensity, measured by a behavioral task, in youth. Results should be taken as quite preliminary, given the small sample. Implications are discussed.
Risk taking; BART; COMT Val158Met; Dopamine; Adolescents
Risk-taking behavior involves making choices with uncertain positive or negative outcomes. Evidence suggests that risk-taking behavior is influenced by emotional state. One such emotional experience is social anxiety, which has been related to both risk-avoidant and risk-seeking decision making. The present study examined a community sample of 34 adolescents grouped into low (Low SA Group) and high (High SA Group) social anxiety (SA). Both groups were compared on changes in performance on a risk taking task (Balloon Analogue Risk Task) between a social threat condition (modified Trier Social Stress Test, High Stress) and a control condition (Low Stress). These conditions were administered on different days, and the order was counterbalanced across subjects. A group x condition interaction revealed that the High SA Group showed greater risk-taking behavior when exposed to the High Stress Condition compared to the Low Stress Condition, while the Low SA Group evidenced no difference between the two conditions. Conceivable interpretations for the increased risk behavior under the condition of social stress for those high in social anxiety are discussed as well as implications for understanding the complex relationship between social anxiety and risk behavior.
Risk-taking behavior; social anxiety; adolescent; in-vivo anxiety manipulation
Both theory and empirical evidence support possible associations between two candidate genetic polymorphisms (SLC6A4 5-HTTLPR l/s and COMT Val158Met – rs4680 variants) and emotion-regulation difficulties. One particular form of emotion-regulation difficulty, distress intolerance, has been measured using a behavioral assessment in youth; data indicate a relationship with poor psychological functioning. No prior study has investigated genetic influences on emotion-regulation difficulties in youth. As part of a larger longitudinal study on adolescent risk behaviors, 218 10-14 year-old youths from the metropolitan Washington, D.C., area completed a measure of distress intolerance, the Behavioral Indicator of Resilience to Distress (BIRD), and provided saliva samples for DNA extraction and genotyping. Results indicate that those with one or two copies of the s allele of the 5-HTTLPR polymorphism were more likely to perform poorly on the task (i.e., choose to quit) than were those homozygous for the l allele. Participants who were Val allele carriers of the COMT Val158Met polymorphism were also more likely to quit the task compared to Met homozygotes. A summative risk allele score was created to combine the two polymorphisms, and each risk allele was associated with a 1.75 fold increased likelihood of quitting the task. Exploratory analyses revealed that emotional abuse moderated the relationship between the 5-HTTLPR and BIRD performance, as well as the genetic risk allele and the BIRD. This is the first investigation of genetic predictors of a behavioral measure of tolerance to distress. Results suggest that distress tolerance is at least partially regulated by specific genetic variants. Implications are discussed.
COMT; 5-HTTLPR; Distress Tolerance
A long line of theoretical and empirical evidence implicates negative reinforcement as a process underlying the etiology and maintenance of risky alcohol use behaviors from adolescence through emerging adulthood. However, the bulk of this literature has relied on self-report measures and there is a notable absence of behavioral modes of assessments of negative reinforcement-based alcohol-related risk-taking. To address this clear gap in the literature, the current study presents the first published data on the reliability and validity of the Maryland Resource for the Behavioral Utilization of the Reinforcement of Negative Stimuli (MRBURNS), which is a modified version of the positive reinforcement-based Balloon Analogue Risk Task (BART).
Participants included a convenience sample of 116 college freshmen ever regular drinkers (aged 18–19) who completed both behavioral tasks; self-report measures of negative reinforcement/avoidance constructs and of positive reinforcement/appetitive constructs to examine convergent validity and discriminant validity, respectively; and self-report measures of alcohol use, problems, and motives to examine criterion validity.
The MRBURNS evidenced sound experimental properties and reliability across task trials. In support of convergent validity, risk taking on the MRBURNS correlated significantly with negative urgency, difficulties in emotion regulation and depressive and anxiety-related symptoms. In support of discriminant validity, performance on the MRBURNS was unrelated to risk taking on the BART, sensation seeking, and trait impulsivity. Finally, pertaining to criterion validity, risk taking on the MRBURNS was related to alcohol-related problems but not heavy episodic alcohol use. Notably, risk taking on the MRBURNS was associated with negative reinforcement-based but not with positive reinforcement-based drinking motives.
Data from this initial investigation suggest the utility of the MRBURNS as a behavioral measure of negative-reinforcement based risk-taking that can provide a useful compliment to existing self-report measures to improve our understanding of the relationship between avoidant reinforcement processes and risky alcohol use.
Adolescence; problem alcohol use; negative reinforcement; risk taking propensity
To investigate the relationship between childhood neighborhood environment and risk-taking propensity in adolescence using an objective environmental measure and laboratory-based risk-taking propensity measure.
Childhood neighborhood disorder predicted risk-taking propensity on a behavioral measure during early adolescence (β=1.8, p<0.01).
Early toxic environments impact laboratory-based behavioral manifestations of risk.
Neighborhood; risk-taking; adolescent behavior; environmental exposure
2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD)-inducible poly(ADP-ribose) polymerase (TiPARP/ARTD14) is a member of the PARP family and is regulated by the aryl hydrocarbon receptor (AHR); however, little is known about TiPARP function. In this study, we examined the catalytic function of TiPARP and determined its role in AHR transactivation. We observed that TiPARP exhibited auto-mono-ADP-ribosyltransferase activity and ribosylated core histones. RNAi-mediated knockdown of TiPARP in T-47D breast cancer and HuH-7 hepatoma cells increased TCDD-dependent cytochrome P450 1A1 (CYP1A1) and CYP1B1 messenger RNA (mRNA) expression levels and recruitment of AHR to both genes. Overexpression of TiPARP reduced AHR-dependent increases in CYP1A1-reporter gene activity, which was restored by overexpression of AHR, but not aryl hydrocarbon receptor nuclear translocator. Deletion and mutagenesis studies showed that TiPARP-mediated inhibition of AHR required the zinc-finger and catalytic domains. TiPARP and AHR co-localized in the nucleus, directly interacted and both were recruited to CYP1A1 in response to TCDD. Overexpression of Tiparp enhanced, whereas RNAi-mediated knockdown of TiPARP reduced TCDD-dependent AHR proteolytic degradation. TCDD-dependent induction of AHR target genes was enhanced in Tiparp−/− mouse embryonic fibroblasts compared with wildtype controls. Our findings show that TiPARP is a mono-ADP-ribosyltransferase and a transcriptional repressor of AHR, revealing a novel negative feedback loop in AHR signalling.
This investigation examined the relationship between living in disordered neighborhoods during childhood and anxiety 1 year later. Objective measures of neighborhood environment and individual data from a study of mental health in suburban children were utilized. Linear regression models were used to assess relationships between neighborhood hazard and anxiety. Childhood neighborhood disorder was inversely associated with generalized anxiety (β = 0.037, p<0.01) and social phobia (β = -0.33, p=0.03), but not other forms of anxiety including separation anxiety or panic disorder. We suspect that children with early exposure to disordered neighborhoods are either desensitized to toxic environments or that anxiety is not well specified for this population.
Effective, parsimonious behavioral interventions that target reinforcement are needed for substance users with depression to improve mood as well as treatment retention. The Life Enhancement Treatment for Substance Use (LETS ACT; Daughters et al., 2008) is a behavioral activation-based approach tailored to increase levels of positive reinforcement among depressed substance users while in substance abuse treatment. The current study tested the efficacy of LETS ACT compared to a contact-time matched control condition, supportive counseling (SC), examining effects on depressed mood, substance abuse treatment retention, and behavioral activation outcomes. Fifty-eight adult substance users in residential substance abuse treatment presenting with depressive symptoms (BDI ≥ 12) were randomly assigned to LETS ACT or SC. Assessments were administered at pre- and post-treatment and included assessment of DSM-IV psychiatric diagnoses, depression severity, treatment motivation, overall activation, environmental reward, and substance abuse treatment retention. Patients in LETS ACT had significantly higher rates of substance abuse treatment retention and significantly greater increases in activation on the Behavioral Activation for Depression Scale (BADS) compared to those in SC. Both groups had decreased depression severity at post-treatment, although the group by time interaction was not significant. This study was the first to compare LETS ACT to a contact-time matched control treatment to evaluate effects on substance abuse treatment retention and two distinct measures of behavioral activation: overall activation and environmental reward. Findings suggest preliminary support for the feasibility, tolerability, and efficacy of a brief behavioral activation-based protocol that may be particularly useful to improve substance abuse treatment retention.
Behavioral Activation; Substance Use; Depression; Treatment Retention; Reinforcement
The present investigation examined the mediating role of distress tolerance in the association between impulsivity and alcohol use coping motives among trauma-exposed individuals. Participants were 86 adults (64.3% women; Mage = 23.4, SD = 9.3) who met the DSM-IV-TR posttraumatic stress disorder (PTSD) criterion A for at least one traumatic life event and endorsed alcohol use in the past month. Distress tolerance at least partially mediated the association between impulsivity and alcohol use coping motives, after controlling for the variance explained by PTSD symptom severity and alcohol use problems. Clinical implications and future directions related to this line of inquiry are presented and discussed.
Impulsivity; Alcohol; Coping; Distress Tolerance; PTSD
The study examined discrepancies in mother and child reports of parental knowledge (PK) of a child’s whereabouts, activities, and companions, as well as the extent to which discrepancies in reports of PK are related to child risk-taking behavior concurrently and prospectively across two time points. The sample consisted of 219 mother and early adolescent youth (Mn age = 11.0, SD = .8) dyads. Mother and child reports of PK significantly differed and, at both waves, scores on the risk taking composite related negatively to both mother and child reports of PK and positively to the discrepancy between the two reports. A significant interaction between mother and child reports was found at wave 2, such that the relation between child reported PK and risk behavior was stronger when mothers reported high levels of parental knowledge versus low levels of parental knowledge. Prospective analyses indicated a main effect of mother report.
Parental Knowledge; Discrepancy; Risk Behavior; Early Adolescence
This paper examined discrepancies between children’s self-perceptions of the riskiness of alcohol use versus their perceptions of the riskiness of alcohol use for other children, and whether these discrepancies predicted children’s future alcohol use. Participants included 234 children (M = 11 years, 45.3% female) who completed baseline and one-year follow-up assessments on self-perceived riskiness of alcohol use, perceived riskiness of alcohol use for other same-age children, and own past year alcohol use. When considering child age and gender, baseline alcohol use, and the individual reports of the riskiness of alcohol use, the interaction between alcohol use riskiness reports prospectively predicted greater odds of alcohol use. The highest percentage of childhood alcohol use at one-year follow-up came from those children with both low self-perceived riskiness of alcohol use and high perceived riskiness of alcohol use for other children. Children’s perceptions of multiple people’s risk from alcohol use results in identifying important subgroups of children at risk for early-onset alcohol use.
alcohol risk; correspondence; disagreement; informant discrepancies; substance use
Little information describes how adolescents change their smoking behavior. This study investigated the role of gender in the relationship of motivation and cognitive variables with adolescent smoking self-change efforts. Self-report and semi-structured interview data from a prospective study of smoking self-change efforts were examined among 98 adolescent smokers ages 14–18 (55% female). Social disapproval motives and short-term consequence reasons for quitting, quit self-efficacy and intentions to quit were modeled in relation to prospective self-quit attempts assessed at a 6-month follow-up, separately by gender. Hypothesized mediating relationships were not supported although gender differences were noted. Social influence motives related to intention to quit and prospective self-quit attempts among girls. For boys, intention to quit predicted making a self-quit attempt. Findings emphasize the importance of examining adolescent models separately by gender and contribute to understanding of mechanisms involved in adolescent smoking change efforts.
adolescent; smoking; process model; self-change; gender
Conceptual models implicating disinhibitory traits often are applied to understanding emergent alcohol use, but, little is known of how inter-individual changes in these constructs relate to increases in alcohol use in early adolescence. The current study utilized behavioral and self-report instruments to capture the disinhibitory-based constructs of sensation seeking and risk taking propensity to examine if increases in these constructs over time related to increases in early adolescent alcohol use.
Participants included a community sample of 257 early adolescents (aged 9-12) who completed a self-report measure of sensation seeking, a behavioral task assessing risk taking propensity, and a self-report of past year alcohol use, at three annual assessment waves.
Both sensation seeking and risk taking propensity demonstrated significant increases over time, with additional evidence that change in the behavioral measure of risk taking propensity was not due to practice effects. Greater sensation seeking and greater risk taking propensity demonstrated concurrent relationships with past year alcohol use at each assessment wave. Prospective analyses indicated that after accounting for initial levels of alcohol use, sensation seeking, and risk taking propensity at the first assessment wave, larger increases in both constructs predicted greater odds of alcohol use at subsequent assessment waves.
Results indicate the role of individual changes in disinhibitory traits in initial alcohol use in early adolescents. Specifically, findings suggest it is not simply initial levels of sensation seeking and risk taking propensity that contribute to subsequent alcohol use but in particular increases in each of these constructs that predict greater odds of use. Future work should continue to assess the development of sensation seeking and risk taking propensity in early adolescence and target these constructs in interventions as a potential means to reduce adolescent alcohol use.
early adolescence; alcohol use; sensation seeking; risk taking propensity
The goal of the current study was to examine the combined influence of positive reinforcement processes using a behavioral task measuring risk taking propensity (RTP) and negative reinforcement processes using a behavioral task measuring deficits in distress tolerance (DT) on a range of risk taking behaviors among early adolescents. Participants included a community sample of 230 early adolescents (aged 9–13) who completed two behavioral tasks assessing reinforcement processes as well as reported on past year risk behavior involvement as assessed by items from the Youth Risk Behavior Surveillance System at a baseline and a 1-year follow-up assessment. Data indicated that at the Wave 2 assessment, RTP was positively related to number of risk-taking behaviors in the past year but only for those with low DT, with this finding persisting after controlling for the significant influence of male gender and higher sensation seeking. Results of the present study highlight the importance of considering both positive and negative reinforcement processes in combination when investigating vulnerability factors for early risk behavior engagement in youth.
Adolescents; Risk taking; Reinforcement processes
Depressive symptoms are associated with poor smoking cessation outcomes and there remains continued interest in behavioral interventions that simultaneously target smoking and depressive symptomatology. This pilot study examined whether a behavioral activation treatment for smoking can enhance cessation outcomes.
A sample of 68 adult smokers with mildly elevated depressive symptoms (M = 43.8 years old, 48.5% female, 72.7% African-American) seeking smoking cessation treatment were randomized to receive either behavioral activation treatment for smoking (BATS) paired with standard smoking cessation strategies including nicotine replacement therapy (n = 35) or standard smoking cessation strategies (ST) alone including nicotine replacement therapy (n = 33). BATS and ST were matched for contact time and included 8 sessions of group-based treatment. Quit date was assigned to occur at session 4 for each treatment condition. Participants completed a baseline assessment, and measures of smoking cessation outcomes (7-day verified point prevalence abstinence), depressive symptoms (BDI-II), and enjoyment from daily activities (EROS) were obtained at 1, 4, 16, and 26 weeks post assigned quit date.
Across the follow-ups over 26 weeks, participants in BATS reported greater smoking abstinence (adjusted odds ratio = 3.59; 95% confidence interval = 1.22, 10.53; p =.02) than did those in ST. Participants in BATS also reported a greater reduction in depressive symptoms (B = -1.99, SE = .86, p = .02) than did those in ST.
Results suggest BATS is a promising intervention that may promote smoking cessation and improve depressive symptoms among underserved smokers of diverse backgrounds.
smoking cessation; behavioral activation; depressive symptoms; low income and minority smokers
Emerging evidence suggests that anxiety sensitivity (AS) predicts subsequent development of anxiety symptoms and panic attacks as well as clinical syndromes in adult samples. The primary aim of the present study was to determine whether AS similarly acts as a vulnerability factor in the pathogenesis of anxiety symptoms among youth in early adolescence (ages 9-13). A large nonclinical community sample of youth (N = 277) was prospectively followed over one year. The Childhood Anxiety Sensitivity Index (CASI: Silverman, Fleisig, Rabian, & Peterson, 1991) served as the primary predictor. After controlling for baseline anxiety symptoms as well as depression, AS significantly predicted the future development of anxiety symptoms. Consistent with the adult literature and expectancy theory, AS appears to act as a risk factor for anxiety symptoms in youth.
anxiety sensitivity; anxiety; prospective; longitudinal
Although a great deal of research focuses on adolescent cigarette smoking, little is known about the process by which adolescents attempt to stop smoking. Resisting temptations to smoke is one of the key challenges encountered by individuals who attempt smoking cessation. A large body of literature has examined coping with temptation among adult smokers, and research on this issue for adolescents is lacking. To further our understanding in this area, the present study reports on an initial examination of the Smoking Temptation Coping Questionnaire (STCQ). The STCQ, which assesses coping in a social pressure situation involving cigarettes, was adapted from the Temptation Coping Questionnaire, a brief self-report measure of adolescent coping with temptations to use alcohol and other drugs.
The present study included 109 adolescent participants (aged 14–19 years) in a naturalistic study of smoking self-change. Participants completed baseline and 6-month follow-up interviews.
Exploratory factor analysis of the STCQ coping scale yielded a single factor including six strategies for coping with temptations. Analyses provided support for the concurrent, predictive, and construct validity of the STCQ. In particular, the coping scale score significantly predicted prospective duration of abstinence for adolescents who engaged in smoking cessation efforts.
These results provide preliminary support for the utility of the STCQ. In addition, findings support the role of temptation coping in the adolescent smoking cessation process.
Little is known about how initial change following a smoking intervention relates to longer-term smoking outcomes among adolescent smokers with psychiatric comorbidity. The present study investigated this relationship among psychiatrically hospitalized adolescents (N=183) who participated in a controlled trial comparing motivational interviewing to brief advice. Quit attempters (n=37), reducers (n=45), and maintainers (n=101) were assembled based on, respectively, having made a quit attempt, having reduced smoking by at least 50%, and having reduced smoking by less than 50% in the first week after hospital discharge. Hierarchical linear models and generalized estimating equations were conducted to test group differences in average number of cigarettes per smoking day and odds of making a quit attempt during subsequent weeks of a 12-month continuous follow-up, and in cotinine-verified abstinence rates at 1, 6, and 12 months posthospitalization. Baseline smoking levels and presence of a substance use disorder or anxiety disorder were predictive of outcomes. After controlling for covariates, we found that quit attempters smoked less during follow-up than did the other change groups and that reducers smoked less than maintainers. Quit attempters evidenced a higher percentage of quit attempts during follow-up than did the other change groups. Reducers had a greater average percentage of quit attempts during follow-up than did maintainers. However, groups did not differ on cotinine-verified abstinence rates across the follow-up period. Findings have implications for initial post-treatment change as it relates to subsequent smoking and cessation outcomes among adolescent smokers at especially high risk for smoking persistence.
A large body of research has examined the development of internalizing and externalizing symptoms in childhood and early adolescence. Notably, there is significant concomitant impairment associated with early adolescent symptomatology, as well as association of these symptoms with future development of psychopathology, poor physical health, self-destructive thoughts and behaviors, criminal behavior, and HIV risk behaviors. Drawing on negative reinforcement theory, the current study sought to examine the potential role of distress tolerance, defined as the ability to persist in goal-directed activity while experiencing emotional distress, as a potential mechanism that may underlie both internalizing and externalizing symptoms among 231 Caucasian and African American youth (M age = 10.9 years; 45.5% female; 54.5% Caucasian ethnicity). A series of regressions resulted in significant moderated relationships, such that low distress tolerance conferred increased risk for alcohol use among Caucasians, delinquent behavior among African Americans, and internalizing symptoms among females. Clinical implications, including the potential role of negative reinforcement models in early intervention with young adolescents, are discussed.
Negative Reinforcement; Distress Tolerance; Alcohol; Externalizing Behavior; Internalizing Symptoms; Adolescents